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Corner Clinic: Helping Kids Swallow Pills, Earbud Safety, Vaginal Discharge


By UC San Diego Health Experts   |   June 26, 2019

Our experts answer your questions on everything from headaches to tummy aches. This month, our experts discuss when kids should transition from liquid medicine to pills, earbud safety tips and when vaginal discharge is concerning.


  1. When should my child transition from liquid medication to pill form?
  2. Do earbuds pose a threat to my hearing?
  3. When is vaginal discharge concerning?
Ben Shleifer

When should my child transition from liquid medication to pill form?
Benjamin Shleifer, MD, pediatrician, UC San Diego Health

Teaching your child how to swallow pills can be daunting for parents and scary for your child, but it does not have to be!

Though a good majority of medicines come in liquid, chewable and dissolvable forms, there will come a time when it will be much more convenient (and palatable) for your child to swallow a pill.

Most children from a developmental standpoint can start learning to swallow pills by Kindergarten age, but it doesn’t always come naturally. Not being able to swallow pills is actually quite common. Even teenagers and adults can struggle with swallowing pills.

Just like learning any new skill, swallowing a pill takes lots of practice and patience. The key to making this a rewarding and confidence boosting experience for your child is creating a stress free environment and trying out some different techniques to see which work best.

Here are some general expert tips to help your child swallow a pill:

  • Have your child sit it up straight with their head centered and straight.
  • Avoid tilting the head too far back, which can make swallowing more difficult.
  • Have your child take a few sips of water to “practice” swallowing.
  • Then, put the pill on your child’s tongue and have him or her drink the water again. (Sometimes having kids drink through straws can help distract them by focusing on something different.)
  • Interestingly, when we turn our heads to the side, the esophagus opens wider, so some children may benefit from swallowing pills with their heads turned to the side. Work with your child to figure out the most comfortable head position for them to successfully swallow a pill.
  • Another recommendation is to have your child practice swallowing pills by using candy first. Start small and then go up in size (example: a cake sprinkle then a mini M&M and then a regular sized M&M).

Most kids will learn how to swallow pills with time and lots of practice;
however there are certain situations where I recommend that parents speak to their child’s doctor first before attempting swallowing training:

  • Kids with developmental delays; oral-motor problems (such as difficulty with swallowing in general, speech problems or refusal to eat certain food textures), or behavioral concerns (kids who are very anxious about trying new things/medicines).
  • Kids who have had a bad experience when they previously tried to swallow a pill (like gagging/vomiting). 
Maureen Spriggs

Do earbuds pose a threat to my hearing?
Meghan K. Spriggs, AuD, certified audiologist, UC San Diego Health

Protecting our ears from damaging noise is an important measure to prevent noise-induced hearing loss. There are two primary variables to consider when enjoying music with earphones: the volume of the sound and the duration of exposure.

Earphone selection may affect your preferred volume level for listening:

First, let's talk about that bass. Bass is what everyone loves about music! Bass provides the thumping power of rock music and the full and rich resonance of classical music. Headphones that cup over the ear keep bass from "leaking," sending it effectively to the ear for our enjoyment. Earbuds tend to be poorer at sending the bass to the ear so many listeners will increase the volume setting to compensate for this.

Next, let's consider listening environment. Unless you're listening in a silent room, you're probably going to turn up the volume of your music to overcome background noises you don't want to hear (such as gym equipment, traffic outside, household appliances, your mom telling you to clean your room). Headphones generally do a better job of blocking out surrounding noises so you don't have to blast your music to enjoy it over other sounds. Earbuds provide less environmental isolation so many listeners turn up the volume louder to overcome surrounding background noise. (While we're on this topic, please consider safety if listening during outdoor activities: Be sure you can hear approaching cars, bikes and pedestrians!)

Regardless of earphone selection, the duration of listening is still an important risk factor:

With today's portable music devices, people have greater ability to listen for longer periods. Longer exposure can increase risk of noise-induced hearing loss. One guideline is the "60/60 rule": limit listening to 60 minutes at 60 percent of volume.

If you hear ringing in your ears, have difficulty hearing sounds around you or frequently need to ask for repetition in conversations, it's a good idea to get your hearing tested!

Erin Gross

When is vaginal discharge concerning?
Erin Gross, MD, obstetrician/gynecologist, UC San Diego Health

The first thing to remember is that all women have vaginal discharge. The vagina is lined with mucosa that is always secreting fluid, much like the lining of our mouths. Fluid from vaginal glands, cervical mucus and naturally shedding cells combine to create what we see as discharge. The quality and amount of discharge may vary based on where a woman is in her menstrual cycle due to normal hormonal variations. Normal vaginal discharge is clear to whitish-yellow in color and should not have a strong odor. Discharge may feel wet but should not cause discomfort. Discharge that is irritating or causes itching, is a markedly different color than usual or has a bad odor may be indicative of an infection or imbalance. Making a correct diagnosis requires not only having a professional examine the discharge but also taking samples for evaluation in the lab or under the microscope in the office.

Common reasons for abnormal vaginal discharge may include the following:

  • Yeast or Candida infection: This occurs with growth of too much yeast. Yeast infections can cause itching, soreness, redness or swelling. The discharge in a yeast infection may be thicker, white and clumpy.
  • Bacterial Vaginosis: This is an overgrowth of less-desirable vaginal bacteria. Women with BV tend to have a higher volume of thinner discharge, a fishy odor and irritation with sex. It is easy to treat with prescription medication but can often recur.
  • Sexually transmitted infections, such as gonorrhea or chlamydia can cause increased vaginal discharge that may be yellow or blood-streaked. These infections can be associated with pelvic pain or spotting after intercourse.
  • Unfortunately, studies have shown that we are not good at self-assessing whether or not we have an infection. Home remedies, such as douching or placing yogurt or garlic in the vagina, can actually do more harm than good. The vagina is naturally populated with healthy bacteria, like lactobacillus, that keep the ecosystem down there healthy. Disrupting this balance with self-treatments can actually result in more problems. We think of the vagina as a ‘self-cleaning’ system and douching disrupts this balance.

    Good guidelines for keeping your vulva and vagina healthy are to not over-clean. Bathing more than once a day is not recommended, avoid harsh or antibacterial soaps, wear cotton underwear, and avoid feminine-care products, like douches, sprays or wipes, unless recommended by your doctor.

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